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Friday, February 12, 2016

Can resilience inoculate vets against burnout, depression and suicide?

Psychologist Nadine Hamilton has some positive solutions for the veterinary profession.

First
the good news: we are seeing unprecedented action focusing on improving the
well-being of members of our profession. The bad news, of course, is that we
need this so much. Psychologist Nadine Hamilton has just submitted her PhD on
psycho-educational intervention in veterinarians and has used this data to
create a novel intervention program. She chatted to SAT about the elements of
well-being, stress in the profession and the benefits of positive psychology.

What is your day job?

I have run my own private psychology practice on
the Gold Coast for the past five years, which essentially has focused on
counselling. However, due to the success of my doctoral research, I am
dedicating my work to my passions – training and educating people to help them
achieve and maintain wellbeing, so they can live a life they love.

Lately we've heard a lot about
suicide prevention, burnout and depression and awareness around mental health
issues in the profession. How common are these problems?

Sadly, they are very common. Research has
shown the veterinary industry to be around four-times more likely than the
general population to suicide, and twice as likely as other health
professionals. There are many contributing factors to stress, burnout,
depression, and suicide, and my research identified some key triggers being:
performing euthanasia, dealing with difficult clients, financial issues, and
unrealistic expectations (both on themselves and by others). In the
general population, it is estimated that around 1 in 5 people will experience
some type of mental illness within their lifetime.

We hear a lot about stress and
burnout in the veterinary profession, but surely we're not alone in this. Are
there other professions that suffer comparable rates of stress and burnout?

Absolutely! Perhaps one of the closest
professions is the construction industry, with estimates of suicide around 1 in
3. In particular, fly-in fly-out (FIFO) workers are at a high risk due to
the demands of their jobs, being away from home, loneliness, relationship
issues, and so-on. Also, many health professionals are also ‘up there’ –
such as doctors, dentists, anaesthetists, psychologists, and
psychiatrists.

Can we really inoculate ourselves
against these, or are they inevitable?

I believe we can inoculate ourselves – but, and
this is a big BUT…..we have to be aware of it first and be prepared to take
proactive steps to do something about it. As an example, in the US the
founder of positive psychology (Martin Seligman, PhD) reported that they
retrained the entire US Army in resiliency skills.

They investigated why some soldiers returned from
war and developed post-traumatic stress disorder (PTSD) and yet others
didn’t. When they researched this, they found that the ones who didn’t
experience PTSD were the most resilient! Likewise, with any profession,
why is it that some people are affected and others aren’t? I do think
this comes down to their coping skills, personality, optimism, and
resiliency.

My intervention program provides participants with
evidence-based, effective strategies to help them address psychological
wellbeing from many different levels.

So many excellent mental health
resources are couched in terms of suicide prevention. Is there a chance this could
alienate people who are suffering from distress but don't feel they are
suicidal?

I think that’s a great point! And
potentially, I think it could alienate people. Also, I think there is so
much stigma around mental illness and mental health that many people don’t want
to know about it, or they are in denial about how serious things might actually
be for themselves. I tried to promote my intervention program as a
“wellbeing” program, in an effort to avoid this stigma.

How can positive psychology enhance
the well-being of veterinary professionals?

I am a huge advocate for positive psychology!
Personally, I think that for veterinary (and other) professionals who are
experiencing any psychological issues, effective psychological coping tools are
necessary (personally I prefer Acceptance and Commitment Therapy (ACT) as
opposed to some of the more common interventions, as I find it is fairly easy
to use and implement, but can be extremely effective).

If I am working with clients for psychological
issues, I like to use ACT, but supplement it with positive psychology (as I
believe it is necessary to have strategies that help you deal with unhelpful
thoughts and feelings, which ACT does). Positive psychology is
essentially about “the good life” and focuses on all the things that are
“right, or positive” in your life, instead of getting caught up in all the
things that are “wrong, or negative”.

Typically we are so focused on all the things we
don’t like, or aren’t happy with, and we dwell on them. When we do this
we lose sight of the good things we DO have, so positive psychology reminds us
that despite the not-so-good things, there are still things to be grateful
for. I also love positive psychology because I find it a great
intervention to use to enhance wellbeing. As well as identifying our
character strengths and working to enhance them, it also uses exercises such as
gratitude, random acts of kindness, three good things, the perfect day,
positive relationships, engagement, positive emotions, meaning and purpose, and
accomplishment.

Therefore, as I mentioned earlier, not all
veterinary professionals will be feeling stressed, burnt out, depressed, or
suicidal, and I feel that positive psychology is a great way to be able to
maintain and enhance that level of wellbeing.

Can you tell us about your
workshop?

Sure! The workshop in my research was run as
a one-day program, mainly due to time constraints for participants.
However, the workshop I’m holding on 22- 23 March will be 1.5 days to allow
additional time and to make it less-rushed.

It was also run in 2014 as a pilot program within
the general community (funded by Gold Coast Medicare Local), and was a huge
success. When I developed the program, I tried to incorporate all the
things I thought were essential for wellbeing, and this included:

how to set SMART goals that you can actually
achieve - after all, if you don't have goals, how do you know where you're
headed

effective stress management techniques to help
manage stress the healthy way

evidence-based psychological exercises for
achieving - and maintaining - wellbeing based on the concepts of positive
psychology

evidence-based strategies for dealing with
unhelpful thoughts and feelings more mindfully, so you can respond in more
helpful ways and achieve much better outcomes in the long run

easy ways to build your resiliency and develop a
resilient mindset

how to manage your time and become more organised

simple - but potent - ways to deal with difficult
people more assertively

basic relaxation exercises that will help you to
feel more calm and balanced.

How do we know this approach
works?

When we analysed the data from the intervention
program, it returned statistically significant results for reducing anxiety,
depression, stress, and negative affect – so it was very promising
indeed!

Do you have any advice you want to
share with vets or future vets?

Please don’t be afraid to talk to someone if you
are struggling with anything – it is not a sign of weakness…in fact, I think it
takes an incredible amount of courage to admit something isn’t right, and to
try and take proactive steps to address it! I have so much admiration for
those who take control of their wellbeing and realise they are worth it!
But I also want to emphasise that you can take proactive steps to maintain and
enhance wellbeing, and it’s not all doom-and-gloom.

Thank you Nadine. For more information about the workshop, visit the website here.

1 comment:

We have been training our staff in this field for the last 5 years, with emphasis on mindfulness, conflict competencies, non-violent communication, communication skills, and coaching for the team through to one-to-one conversations.

There has been appreciable differences in how we approach difficult conversations. However, like all learning processes, it gets harder before it gets easier.

When exposed to these approaches, like the new tool, every problem starts to look like a nail; and that's okay, but we need to continue to push the limits of people's perspective taking capacity.

There is some very interesting work on Mental Toughness with training/workshops now available to veterinary staff in Australia. In addition, there is a lot of information in the human ER/CC field on Stress Innoculation and Developing Resilience.

Veterinary Ethics: Navigating Tough Cases

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